First Source Anesthesia, LLC

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

Legal business name

FIRST SOURCE ANESTHESIA, LLC

Practice address

577 Mulberry St Ste 110
Macon, GA 31201-8220

Phone

(888) 728-0882

NPI assigned

Jan 15, 2016

Last updated

Aug 14, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Richard Douberly, CRNA

Title

Member Manager

Phone

(888) 728-0882

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jannine Gundersen Taylor, CRNA

  • Certified Registered Nurse Anesthetist
  • Peachtree City, GA
  • NPI 1073625588

  Nurse Anesthetist, Certified Registered

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1452816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597363200000",
    "number": "1558728907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 850001",
            "address_2": "DEPT #249",
            "city": "ORLANDA",
            "state": "FL",
            "postal_code": "328850249",
            "telephone_number": "888-728-0882",
            "fax_number": "888-512-1507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "577 MULBERRY ST STE 110",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312018220",
            "telephone_number": "888-728-0882"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4080 McGinnis Ferry Rd",
            "address_2": "Suite 102",
            "address_purpose": "LOCATION",
            "city": "Alpharetta",
            "state": "GA",
            "postal_code": "30005",
            "country_code": "US",
            "telephone_number": "888-728-0882 x7",
            "fax_number": "888-512-1507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FIRST SOURCE ANESTHESIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-15",
        "last_updated": "2020-08-14",
        "certification_date": "2020-08-14",
        "status": "A",
        "authorized_official_last_name": "DOUBERLY",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "MEMBER MANAGER",
        "authorized_official_telephone_number": "888-728-0882",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• First Choice Primary Care, Inc
• First Choice Primary Care, Inc.
• First Choice Primary Care, Inc. (FCPC South Macon Family Physicians)
• First Choice Primary Care, Inc. (First Choice Primary Care, Inc. At Daybreak)
• First Option Medical
• Paul Gerald Firth, MD
• Kasey Eavenson Fish, NP-C
• Christine Michelle Fite Day, CRNA
• Alan A Fite, CRNA
• Travis Fite

• Certified Registered Nurse Anesthetist in Macon, GA
• Providers in Macon, GA by specialty
• Certified Registered Nurse Anesthetist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.